NEW YORK (Reuters Health) - Pregnant women who suffer a
miscarriage in the second-trimester are at high risk during a
subsequent pregnancy of a spontaneous preterm birth and repeat
second-trimester miscarriage, a study indicates.

Dr. Michal A. Elovitz and associates studied three groups
of women: 30 women who had a spontaneous second-trimester
miscarriage; 76 women with a spontaneous preterm birth; and 76
women with full-term deliveries. All of the women had a
subsequent pregnancy beyond 14 weeks' gestation.

They frequency of subsequent second-trimester loss was
highest (27 percent) in women who suffered a second-trimester
loss in the first pregnancy, they report.

The frequencies of subsequent second-trimester loss were 3
percent and 1 percent in the spontaneous preterm birth, and
full-term delivery groups, respectively.

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Corresponding frequencies of subsequent spontaneous preterm
birth were 33 percent, 39.5 percent and 9 percent for the three
groups, respectively.

"Of great clinical concern," the team notes, "is that women
with prior second-trimester pregnancy loss have a high
frequency of very early preterm birth."

In this group, spontaneous preterm birth at less than 28
weeks was 10 percent, versus 1.3 percent in the other two
groups.

The researchers suggest that the biologic mechanism for
second-trimester losses may be similar to that of spontaneous
preterm birth, possibly related to "cervical ripening" as a
primary event. If so, "women with second-trimester loss would
be candidates for therapy that reduces subsequent preterm
birth," they suggest.